Interference of Hb D Variant on the Measurement of HbA1c by Lifotronic H8 Ion-Exchange High-Performance Liquid Chromatography (HPLC)

Hemoglobin A1c (HbA1c) is used to monitor long-term glycemic control. In the presence of hemoglobin variants, erroneous results may be observed in HbA1c measurements. In this case, we describe a patient whose hemoglobin A1c (HbA1c) result was measured with an ion-exchange high-performance liquid chromatography (HPLC) device and found to be 3.1%. Hemoglobin D(HbD) variant was detected in electrophoresis measurements for further investigation, and the patient's true HbA1c value was 5.1%. In case of very low HbA1c results or measurements inconsistent with the patient's clinic, analysis with methods such as electrophoresis resistant to hemoglobin variant interferences is recommended instead of ion exchange HPLC.